Effective January 1, 2020 for all groups, Delta Dental of Kansas updated our scaling and root planing process policies. When scaling and root planing (SRP) is performed on more than two quadrants on the same day, the claim will be referred to dental consultants for review of all submitted quadrants.

Review Criteria:

• There must be 4 or more periodontally affected teeth in a quadrant to qualify for D4341.
• Exposure of cemental surfaces of the root is necessary for root plaining, therefore radiographs must show the crest of the alveolar bone greater than 1.5 mm apical to the CEJ.
• Submit periapical or bitewing radiographs and periodontal chart documenting probing depths, amount of attached gingiva and clinical attachment levels.

Please Note: panoramic radiograph (D0330) are not accepted for SRP claims documentation and determination. According to the American Academy of Periodontology, panoramic X-rays have limited value in the diagnosis of periodontal disease.